MEDICARE: CHRISTOPHER IAN TRAVIS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	207V00000X	Obstetrics & Gynecology Physician	35.148800	OH

General Provider Information

NPI Number	:	1447814389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER IAN TRAVIS MD

Provider Business Mailing Address
First Line	:	8055 MAYFIELD RD STE 105
Second Line	:
City	:	CHESTERLAND
State	:	OH
Zip	:	44026-2447
Country	:	US
Telephone Number	:	440-214-8026
Fax Number	:	216-201-7963

Provider Business Practice Location Address
First Line	:	25001 EMERY RD STE 125A
Second Line	:
City	:	WARRENSVILLE HEIGHTS
State	:	OH
Zip	:	44128-5626
Country	:	US
Telephone Number	:	216-844-3941
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2019
Last Update Date	:	03/27/2025

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